Remote Senior Manager - Credentialing & Provider Data

Centene Corp.; United States; Hybrid; USD 88,000 - 158,000; Full time

Benefits offered by this job

Health insurance

401K and stock plans

Tuition reimbursement

Paid time off

Holidays

Flexible work arrangements

Job summary

Centene Corporation is seeking a Senior Manager of Credentialing and Provider Data Management to oversee all credentialing and provider data entry processes, from triage through enrollment and ongoing data maintenance.

The role requires a bachelor’s degree and 4 years of relevant experience with NCQA credentialing knowledge; supervision of a technical team; strong SQL Server experience; and the ability to ensure compliance with state and federal regulations.

Qualifications

• Bachelor’s degree or equivalent with 4 years of relevant experience.
• NCQA credentialing and provider data management knowledge required; 3+ years of supervisory/management experience.
• Preferred experience with Portico, Amisys, CenProv.

Responsibilities

• Lead a team supporting credentialing and provider data management from a technical perspective including system updates and enhancements, data analysis, and reporting.
• Oversee credentialing and re-credentialing of physicians, mid-level practitioners and organizational providers.
• Manage updates to provider data, including training materials, policies, and procedures.
• Ensure updates for provider records comply with health plan policies and state/federal regulations.
• Monitor KPIs, NCQA credentialing standards, and state/federal requirements.
• Manage updates to and production of hard copy and online provider directories.
• Ensure accuracy of provider enrollment specifications and demographics.

Skills

SQL Server

PDM

Credentialing

Leadership

Education

Bachelor's degree

Tools

Portico

Amisys

CenProv

Job description

Centene Corporation is seeking a Senior Manager of Credentialing and Provider Data Management to oversee all credentialing and provider data entry processes, from triage through enrollment and ongoing data maintenance.

The role requires a bachelor’s degree and 4 years of relevant experience with NCQA credentialing knowledge; supervision of a technical team; strong SQL Server experience; and the ability to ensure compliance with state and federal regulations.